| NPI | 1578082020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA NICOLE PRIMM VP Of Payer Relations 815-391-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0601-0052-A) |
| Enumeration Date | 2017-09-15 |
| Last Update Date | 2023-12-11 |